The abortion pill, also known as the medical abortion, is one option available to terminate pregnancy between 5 and 8 weeks. Unfortunately, many people have little or no information about the abortion pill – so when offered this choice they feel confused. Many questions often spring to mind. Is it ‘easier' then the tropical surgical procedure? How does the medication work? Is there pain involved? Is it right for every patient? These are questions which should be discussed with your provider and your support people. However, here are some of the basic facts.
Is it ‘easier' to have a medical abortion then a surgical abortion?
In most cases when patients have asked this question it is because they believe that they will simply take one pill and leave the office having completed the medical abortion process. If only it were that simple! What you want to consider when deciding between a surgical or medical abortion is what will make you more comfortable.
The abortion pill procedure is less invasive then the surgical procedure. The doctor does not manually dilate your cervix. You don't require anesthesia. These are things which can make this an appealing choice. There are of course some trade offs. With the medical procedure you will send several days involved in going through a miscarriage at home. While this allows more privacy, it takes time and means you will have to follow you medical providers' instructions.
How does it work?
Mifepristone, also know as UR 486, is an FDA approved medication which blocks progesterone, one of the hormones needed for the pregnancy to continue to develop. This medication, prescribed under a doctors supervision, is taken after the patient has made her decision to terminate the pregnancy and all the necessary testing has been gone over by the doctor. This medication does not complete the procedure however. For the termination to be safely completed a second set of pills called Misoprostrol need to be taken 36 hours later. This second medication causes the uterus to contract and expel the pregnancy tissue in a controlled miscarriage.
How will I feel?
Most women do not have any physical reaction to the Mifepristone, although sometimes this medication alone is enough to start the miscarriage as the pregnancy stops developing. Some patients have reported having spotting, cramping and bleeding several hours after taking the first pill.
It is the Misoprostol which normally causes the miscarriage, so when you are preparing to take this medication it is important that you are in a comfortable place where you can relax. You will want to take pain medication as directed by your doctor during this time to ease the cramping. In most cases the heaviest cramping and bleeding happens between 3 and 12 hours after taking the misoprostol. The bleeding may be heavier then a normal period.
Will I need a D & C?
In 95% of the cases where the medical abortion procedures are followed the patient does not need a D & C. There is the 5 % possibility that the miscarriage may not be complete. This is why going to your follow up with the provider is so important. If you are one of those 5 % you will need to have a D & C to remove any remaining tissue or blood clots which could cause infection. You should not consider the medical abortion complete until you have this confirmation from your doctor.
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